Provider Demographics
NPI:1336105469
Name:RAY, STARLING SPEED III (DMD)
Entity Type:Individual
Prefix:DR
First Name:STARLING
Middle Name:SPEED
Last Name:RAY
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 HICKORY RD
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-2204
Mailing Address - Country:US
Mailing Address - Phone:843-530-1500
Mailing Address - Fax:
Practice Address - Street 1:721 OKATIE HWY170
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29936
Practice Address - Country:US
Practice Address - Phone:843-987-7400
Practice Address - Fax:843-987-7498
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZX1653Medicaid